Hu Qiang, Wang Jindong, Liang Jing, Xiu Meihong, Zhang Shuangli, Wu Fengchun
Department of Psychiatry, Zhenjiang Mental Health Center, Zhenjiang, China.
Qingdao Mental Health Center, Qingdao, China.
Int J Neuropsychopharmacol. 2024 Dec 1;27(12). doi: 10.1093/ijnp/pyae063.
Gonadal hormones have been reported to be involved in the molecular mechanisms of schizophrenia (SCH). However, only a few studies have examined the gonadal hormone dysfunctions in first-episode schizophrenia (FES) patients, in particular in young patients with SCH. This study was designed to investigate the sex differences in gonadal hormones in young and antipsychotic-naïve FES patients.
One hundred and sixty-two patients with SCH and 74 healthy controls were recruited, and blood gonadal hormones, including estradiol (E2), follicular-stimulating hormone (FSH), progesterone (PROG), luteinizing hormone (LH), and testosterone (TESTO), were measured in young FES patients and controls.
We found that both male and female young FES patients showed gonadal hormone disturbances at the onset of psychosis. Male patients exhibited a significantly higher rate of abnormal E2 (25.6% vs 3.9%), while female patients had higher rates of abnormal FSH (0% vs 5.3%), PROG (0% vs 21.1%), LH (3.5% vs 17.1%), and TESTO (3.5% vs 13.2%) (all P < .05). Multivariate logistic regression analysis further identified that specific gonadal hormone indices, including E2, LH, and TESTO, were factors associated with sex differences in young FES patients, after controlling for age, smoking status, and body mass index.
Our study reveals an overall gonadal hormone imbalance in young antipsychotic-naïve FES patients, highlighting sex differences at the onset of psychosis. Our study provides a foundation for further research into the role of gonadal hormones in the pathophysiology of SCH and the potential for personalized medicine approaches based on hormonal balance. Future studies were warranted to explore these differences and their implications for clinical practice to improve the treatment outcomes for individuals suffering from SCH.
据报道，性腺激素参与了精神分裂症（SCH）的分子机制。然而，仅有少数研究考察了首发精神分裂症（FES）患者，尤其是年轻的精神分裂症患者的性腺激素功能障碍。本研究旨在调查未使用过抗精神病药物的年轻FES患者性腺激素的性别差异。
招募了162例精神分裂症患者和74名健康对照者，测量了年轻FES患者和对照者血液中的性腺激素，包括雌二醇（E2）、促卵泡生成素（FSH）、孕酮（PROG）、促黄体生成素（LH）和睾酮（TESTO）。
我们发现，男性和女性年轻FES患者在精神病发作时均出现性腺激素紊乱。男性患者E2异常率显著更高（25.6% 对3.9%），而女性患者FSH（0% 对5.3%）、PROG（0% 对21.1%）、LH（3.5% 对17.1%）和TESTO（3.5% 对13.2%）异常率更高（所有P < 0.05）。多因素逻辑回归分析进一步确定，在控制年龄、吸烟状况和体重指数后，特定的性腺激素指标，包括E2、LH和TESTO，是年轻FES患者性别差异的相关因素。
我们的研究揭示了未使用过抗精神病药物的年轻FES患者总体性腺激素失衡，突出了精神病发作时的性别差异。我们的研究为进一步研究性腺激素在精神分裂症病理生理学中的作用以及基于激素平衡的个性化医疗方法的潜力奠定了基础。有必要进行未来研究以探索这些差异及其对临床实践的影响，从而改善精神分裂症患者的治疗结局。
